Breastfeeding is important as breast milk provides the best nutrition for most infants, it can protect newborns from many illnesses throughout their infancy and childhood. Your baby should be exclusively breastfed up to 6 months old, and continue with breastfeeding with added complementary foods up to 2 years of age and beyond. Breastfeeding is especially effective in protection against infectious diseases as it strengthens the immune system of the child by directly transferring the mother’s antibodies through breast milk. With the current pandemic of coronavirus disease going on, many mothers are wondering if it is safe to continue the practice of breastfeeding if they are having COVID-19. As with all cases of suspected or confirmed COVID-19, it is vital to undergo corona testing if you are a mother who is breastfeeding and present with any symptoms of COVID-19, as precautions should be taken to minimize the risk of spread of the disease.
Based on the currently limited evidence available, the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, through breast milk is not likely as the transmission of the virus through breast milk and breastfeeding has not been detected till date. Considering the advantages of breastfeeding and the unlikely role of breast milk in the transmission of SARS-CoV-2, it is safe to continue breastfeeding while adhering to all the required precautions. Whether or not to continue breastfeeding and the method should be decided by the mother in coordination with her family with counseling from the health-care providers regarding the precautions to be taken to avoid spreading the virus to the infant. As a general rule for mothers who are suspected or confirmed with COVID-19, proper precautions such as respiratory and hand hygiene should be practiced when near your child. If you decide to continue breastfeeding, wash your hands thoroughly with soap or sanitizer with at least 60% alcohol, especially if your hands are visibly soiled before and after touching your baby. Be sure to wear a medical mask or a cloth face covering while breastfeeding. Any surfaces that you touch should be routinely cleaned and disinfected. Your breast area only needs to be cleaned if you have just coughed on it, otherwise, there is a lack of evidence to support precautions such as cleansing the breast before breastfeeding or milk expression.
If you are severely ill with coronavirus disease or if you decide not to continue breastfeeding, you should express the breast milk to safely provide feeding to your infant. If you are expressing breast milk with your hands or with a breast pump, wash your hands or clean all pump or bottle parts before and after each use. Use a dedicated breast pump and the proper way to clean and sanitize breast pumps should be taught to mothers during counseling by health-care providers. If possible, the expressed breast milk should be fed by a healthy caregiver living in the same home, who does not have COVID-19 and is not at high-risk for COVID-19. If you are too unwell to breastfeed or even express breastmilk, you can opt to explore other methods such as wet nursing (another woman breastfeeding your child), using donor human milk, or relactation (restarting breastfeeding after a gap period) depending on your cultural context, availability and acceptability.
Any infant that is being breastfed by a mother who is suspected or confirmed with COVID-19 should be suspected of COVID-19 for the duration of the mother’s recommended period of home isolation and 14 days thereafter if the infant’s testing results are not readily available. You may seek counseling, basic psychosocial support, and practical feeding support if you or your infants are suspected or confirmed with COVID-19. Unfortunately, there is still a lot that we do not know regarding COVID-19, but most international health organizations do advise that breastfeeding is safe and advisable during this pandemic with proper precautions taken.